Note: This piece is translated from Yibao Chinese by Yan Li, Evan Osborne, and Alina Wang, slightly edited for clarity’s sake. In it a physician retransmits an account from someone who reposted it on WeChat later that month, and where the doctor who wrote the original account is referred to as Dr. Huan (huan1806). While Western reporters filed numerous reports after visiting hospitals in December 2022 and January 2023, this is a rare firsthand account from a Chinese health worker himself.
The History of Medicine
The story of one’s own medical work today is the history of medical science tomorrow.
[Re-poster’s note As the old year ends and the new one begins, some people are celebrating the New Year and enjoying the ability to at last breathe freely; but on the other side of the coin, almost all medical institutions are undergoing severe pressure amid the “total battle” against Omicron. Today, I am copying an article written by a colleague, upon request by the author without attribution, with photos taken by me. Dr. Huan works in the emergency department of a general tertiary- care hospital in the city and here records this dark moment in the history of medicine.]
On the last day of 2022, our emergency room reported the following figures: 1,987 visits, 175 ambulance arrivals, and 241 patients admitted to the hospital.
The emergency room in front of me currently is seemingly a dense sea of black and gray. This is the patient population, scattered among whom are dots of bright blue constantly in motion. These are the medical workers. The color of the floor can not be seen at all, having long been concealed beneath this mass of people. There is all manner of ambulance stretcher, some chest-high, some coming only up to the ankle, and walking carelessly is an easy way easy to step on a patient on the floor.
All lines — to check in, to check -out, to get a test, to talk to a medical person, to get an IV inserted — are more than 100 meters long. see people lining up with their folding chairs. The air is filled with a foul myriad of odors. No one remembers now to be concerned about any viral droplets. I use the thickest N95 mask merely to block the smells, and never take it off during my 8-hour shift. This plus my own nasal congestion means, I cannot smell anything for a long duration.
When I get back to my car, I take off my mask and drink a lot of electrolyte-infused water, or open my middle-aged man’s thermos, with its wolfberries and “American ginseng” [two food ingredients often recommended in traditional Chinese medicine]
After calming my pulse and breathing, and after some rest, I can drive home, where my daughter is still waiting for me to cook our New Year’s Eve dinner by hand.
This work, which was called the “decisive battle,” lasted for half a month. Sixteen of the nineteen doctors in the ICU tested positive. Before the hospital’s “backup unit” arrived, members of the team were struck by COVID but had to quickly return to work. The longest rest period for any infected doctors was four days, many could not take any days off at all, and as long as one did not have a high fever one had to return to work.
Many colleagues who returned to duty, especially several female colleagues, were still extremely weak after their return, drowning in each new wave,s of patients, which could appear at any time. Their voices were hoarse, and they coughed more often than the patients themselves during consultations.
Breakfast was extremely important to me. It had to be high in sugar and calories. There were days when I had to force myself to eat, even when in danger of losing consciousness, feeling nauseous or otherwise finding it very difficult to eat. I carry one of my daughter’s cartoon Band-Aids from the movie Frozen with me every day, in order to protect the bridge of my nose. Because an N95 mask fits very tightly and places a great deal of pressure on the bridge of the nose, without this Band-Aid protection, the skin there tears after only two days.
During the most critical days of this “war,” essentially all the team members had fallen at one point or another, and we simply could not allow another to do so. Only this week, after infected colleagues returned to work one by one was the terror of “testing positive” alleviated.
I can’t remember the last day I ate lunch at work. My breakfast now has to give me all the energy I need for the entire day. As the workload got heavier, if I were to choose to eat lunch, I would have to put on and later take off protective gear as I walked between the cafeteria and the emergency room, which takes at least half an hour. But our rounds currently end at noon, and at that time there are still a million things I need to deal with. The time saved is enough for me to take care of several patients.
What we are capable of is actually unlimited. I used to invariably have lunch around 11:00. Now, from the moment I rush into the resuscitation area at the beginning of my shift fully dressed, my adrenaline starts to spike and my heart rate, blood pressure, and blood sugar are all elevated. Even if fatigue is written all over my face, I can still manage to work in full gear after the shift starts. This exhausting routine lasts 8 hours a day, during which I do not eat, drink, or urinate. But I feel satisfied as long as I can leave work at peace.
It has been more than a week since I last wrote something for the public, and the working environment in the emergency room (ER) is getting worse and worse. We predicted the peak of patients was coming, but every day the number of new ones keeps setting records; the expected peak never comes.
The beginning of my shift at 8 AM is now a well-practiced daily routine. The medical records in the arms of the night-shift doctors are piled up from their waists to their chins. And that’s just the new patients coming in.
Anxious family members of patients rush into the clinic at this moment to inquire about the patients’ conditions and whether there is any hope. Some people directly call for help, saying that their family members need to be saved right now, and some even come to inform the doctors that some patient has passed away. The first message on the shift’s WeChat group is often posted by a colleague from the night shift, relaying how many death certificates still remain to be filled out from the night before and that families will come in during the day with the necessary information about the deceased…
Often it is during this shift-change period of less than half an hour that we have to deal with all kinds of inquiries, questions, rants, and even complaints and threats.
Families were originally informed that personnel was on rounds until 10 am, and told to wait patiently next to the patient until then. Then 12:00 pm, now it’s 1:00 pm…
Every day each doctor is treating 20-25 critically ill patients half of whom are new patients who came to the ER the day before. Families feel hopeless about the future, completely insecure, full of anxiety, panic, and even anger and hostility. So, a large part of the daily work of doctors is focused on finding appropriate outlets for these patients and families and stabilizing their emotions. It’s not just treating the patients’ disease.
Needless to say, the devastation this epidemic has brought to normal lives is almost as bad as that brought by war. There is so much helplessness and despair encountered every day. People living in all corners of the city see hospitals as the last hope, because their greatest desire is to stay alive.
The conflict between medical supply and demand is so striking that anyone can sense it. Oxygen and beds are hard to find, and oxygen and even pillows in medical- equipment stores have been snapped up. Secondary hospitals and private and foreign hospitals that usually have a high vacancy rate are said to be at capacity.
One patient’s family member even said to me that our emergency room has become a dog-eat-dog jungle. He stayed in the hospital for a few days and saw too many deaths, which made him want to flee. He said his decision to transfer his family member from a hospital ward in Lingang to our hospital was the worst of his life. So, he asked me to help contact other nearby hospitals regardless of quality, just seeking a quiet hospital bed where he could preserve some last measure of dignity for his family.
Facing life or death, some people are struggling, some are merely waiting for fate, and some just give up.
A 99-year-old woman, Mrs. Lü, had been in the emergency room for three days when I checked in to see her for the second time. Her two daughters were in their 70s. In the densely packed, crowded waiting hall, three elderly women huddled in a corner. There were perhaps as many as a dozen people in the few square feet of space around them.
The elder daughter said to me, “Doctor, can you give me a basin? , I want to wash my feet…” I was baffled by the question. A few minutes later, the youngest daughter came to me. She said that her elder sister had not closed her eyes for two days had been unable to eat, and was in a trance. The family discussed it and decided to take Mrs. Lü home. I asked, “Do you want to bring some medicine that can be taken orally back home? “ The younger daughter said it would take a long time to wait in line to get it, and they really had no strength to do that, so they left.
There was an old gentleman, 90 years old, who called an ambulance to take him from Putuo District to Pudong. I found him in a narrow corridor. The stretcher bed he was sleeping on was just above my ankles. After I bent down and squatted to take his blood pressure, I looked up to see a long, packed mass of people, all waiting for the pharmacy to provide their medications.
I think it was a third-generation family member of this old man who came to me, saying that the old man had always trusted this hospital, and so had clamored to call an ambulance to bring him all the way here to see a doctor. This family member said that, he understood the current situation very well, and would not himself make more demands of us. He said, “I see how difficult it is for the medical staff here, so I won’t bother you anymore. I am going to call an ambulance to take him home and have him take some oral medicine.”
Even before the crisis, the ATM in the emergency room had been unused for a long time. In this digital age, the corner where the machine is located ordinarily goes virtually untouched. Today, almost every inch of that space is occupied. A lonely old man was found next to the ATM. His vital signs are stable, but he has no one with him. The family members of the patient next to him said that the patient’s son was taking care of his other elderly parent, who was receiving IV treatment, on the second floor.
Finally, at noon, the old man’s son came to me and apologized for not being with the old man until now. He said that several people in his family were sick, and the two oldest people were wearing him out, so he had decided to take the old man home directly. I said that the old man was having some problems swallowing and that he might not be able to take his oral medication smoothly for a while. He said: It’s okay, please prescribe the medicine for him, I will have him take it when he can…”
A few words from an older woman in her 60s may be representative of what has happened to many families facing the same disaster.
“Almost all members of my family have fallen sick, the old and the young alike. But there is always someone who must get up and take care of the sick. But human energy is limited. We can’t be infallible, we always have to sacrifice something. It’s fate.”
For me personally, perhaps the toughest time is now behind me.
This past week, five out of seven people in my own extended family tested positive. My mother, who was the weakest and whom we always tried to protect, finally got infected along with my father.My father-in-law, who was over 70, was the first to test positive, and my mother-in-law had to take care of him at home. But my mother-in-law, who has diabetes, was eventually infected as well.
My wife had decided to quarantine at home after being infected in her workplace. It was extremely challenging for me because I couldn’t afford to get infected, since almost all the staff in the emergency room were sick and no one could work. At the same time, my daughter, who was taking online classes from home every day, needed someone to take care of her.
Before I left home for work each morning, I now needed to know the temperatures of my four elderly family members, and I also needed to arrange breakfast plus lunch for my daughter and my wife. I try to leave work on time every day because even if I’m not hungry myself, I need to go home to cook dinner for my family, even if it’s just a simple one-dish meal.
The days when these four elderly relatives of mine had fevers at the same time were the most stressful time for me. My father-in-law said he had been sick for almost a week and his temperature was still 39 degrees [Celsius]. He and his wife decided to come to my emergency room for treatment. I had no time to take care of them beyond issuing them an application for a laboratory test. While I was running back and forth and calling loudly to find my patients, my mother, who lived in the suburbs, called and told me that she still had a persistent fever, along with various other problems, after taking various medicines to relieve the fever. Hearing this, I immediately cried out, “Come to my hospital!” Then I hung up.
I can’t let go of my job, and I can’t give up my work, because my colleagues are working desperately. So, if my family had stayed well, thus letting me work without distraction, it would have been a great blessing.
My cell phone became my biggest necessity to do my job. Receiving the latest hospital policies and notifications, releasing departmental crisis-management information, patient conditions at the change of shift, patient-transfer contact information, and even finding lost patients, all was done via cell phone. However, my cell phone also became my biggest problem while on duty.
In these epidemic times, as doctors, we are constantly bombarded with phone calls. All kinds of inquiries, even requests for help do not cease for even a moment. I witnessed my colleagues dropping their phones in anger.
I have to apologize to everyone, but while working I do not reply to WeChat messages, and I have no time to listen to any kind of voicemail. There are 7-8 groups at the top of my WeChat feed every day, all involving ER work. Many colleagues, friends, and classmates have sought my help, but it is hard for me to provide it because I am just powerless.
On New Year’s Eve, my daughter and some of her classmates were in a group voice chat, and several young girls born after 2010 were sharing the live New Year’s Eve galas of various TV stations, commenting on the performances of the stars of their generation.
In the past, when it came to New Year’s Eve, there were always summaries and expectations as the old year ended and the new one began. Today, it feels like this half-month experience has constituted the entirety of my memories for the year. I have nothing left. It’s been an extraordinary grind, like running a full marathon.
The children at least still have joy in their hearts.
I am looking forward to the time when the light finally returns, and waiting for the moment when we can wave the flag of victory and celebrate.